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MYCETOMA,   OR MADURA-FOOT.            269

Vincent was unable to communicate the disease to animals
by inoculation.

Microscopic study of the diseased tissues in cases of
mycetoma is not without interest. The healthy tissue
is said to be sharply separated from the diseased masses.
The latter appear as large degenerated tubercles, except
that they are extremely vascular. The mycelial or
filamentous fungous mass occupies the centre of the
degeneration, where its long filaments can be beautifully
demonstrated by the use of appropriate stains, Gram's
method being excellent for the purpose. The tissue sur-
rounding the disease-nodes is infiltrated with small round
cells. The youngest nodules are seen to consist of granu-
lation-tissue, which in its organization is checked by the
coagulation-necrosis which is sure to overtake it Giant-
cells are few.

Not infrequently small hemorrhages occur from the
ulcers and sinuses of the diseased tissues ; the hemor-
rhages can be explained from the abundance of small
blood-vessels in the diseased tissue.

Although the disease has been described as occurring
in Scinde, it is not limited to that province, having been
met with in Madura, Hissar, Bicanir, Dehli, Bombay,
Baratpur, Morocco, Algeria, one case by Bastini and
Campana in Italy, and one by Kempner in America.